How and when you get hepatitis D can make a big difference in the course of the infection.
There are two different ways that a person can get the virus.
The differences might not sound extreme, but a superinfection is considered to be a far more serious condition.
Illustration by Paige McLaughlin for Verywell Health
HDV superinfection is also associated with the rapid progression of liver disease.
Genotypes
HDV can also be categorized by its genetic characteristics (genotype).
There are three HDV genotypes that vary by their geographic location and disease pattern (pathogenesis).
The acute stagedevelops soon after the infection is established and can last for several weeks or months.
The chronic phasecan persist for years and even decades.
If theimmune systemis able to scrub the infection, people may not even know that they’ve been infected.
If symptoms do develop, they are difficult to tell apart from those of other forms of viral hepatitis.
Fulminant hepatitis involves extreme liver function failure.
It occurs in less than 1% of all acute HBV infections.
When HDV is involved, the risk can jump to as much as twentyfold.
Chronic Stage
Chronic hepatitis D happens when the immune system is unable to reset the virus.
When it is “decompensated,” the liver is no longer functional.
In most cases, HDV is the dominant virus in the infection.
Any liver damage that occurs, therefore, is the result of hepatitis D rather than hepatitis B.
Hepatitis D ismainly spreadthrough blood exposure.
Shared needles and syringes are among the most common causes.
Sexual transmission of HDV is uncommon but can occur.
HDV transmission from pregnant person to child during childbirth, while possible, is thought to be rare.
Diagnosis
Arguably the biggest challenge in diagnosing hepatitis D is recognizing the signs of infection.
If HDV is suspected, it can be diagnosed using a series of simple blood tests.
The PCR test can both confirm the diagnosis and indicate if the infection is active.
Factors like this can help direct the appropriate course of treatment.
Given the availability of noninvasive tests, aliver biopsyis less commonly used for disease staging.
However, they might be used on an experimental basis in combination therapies.
The injections can be given at home using a traditional syringe and vial or a pen-like autoinjector.
However, the viral load will typically rebound once the treatment is stopped.
Other Treatments
A few experimental drugs have shown promise in the treatment of HDV.
Prevention
The best way to prevent hepatitis D is to prevent hepatitis B.
Although HDV can enter cells on its own, it cannot replicate without HBV.
Without the means to rapidly grow, HDV cannot cause disease.
Infants are typically vaccinated soon after birth and complete the vaccine series by six months of age.
Being under the care of a qualifiedgastroenterologistorhepatologistis key to maintaining your health.
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